Sensory difference

Our senses help us to understand and make sense of the world. Many children with autism have sensory difficulties which can mean that they find it hard to tolerate certain sensations or situations. This section considers what sensory processing is, the common difficulties that children may experience and ways to help.

Sensory processing refers to how we use information provided by all of the senses within our body and from our environments. There are seven senses to consider:

• Touch
• Taste
• Smell
• Sight
• Sound
• Proprioception
• Vestibular

All of the information is received, processed and integrated to give us an understanding of who we are, where we are and what is happening around us.

When our senses are integrated correctly we are able to respond appropriately to the sensation. For example, we will take off an itchy woollen jumper or we may take a deep breath to smell the flowers.

Children who experience difficulties in this area may struggle to understand what is happening inside and outside of their bodies. The sensory information their body is registering may not be accurate.

Imagine how it feels to be a child in pre school when the pictures on the wall repeatedly grab your attention because your brain does not register that it is familiar. When every child around you puts you on high alert, because when someone brushes past you it feels painful. Putting on socks is very difficult because you cannot balance and don't know how to move your hands and feet accurately. Your body is not providing accurate information as to where your arms and legs are, so they need to keep moving to provide that extra feedback.

Most people get used to their own sensory preferences, which enables them to make appropriate choices about their daily activities. However, children with sensory difficulties tend to go with their instincts and may struggle to communicate how they feel. They may appear disorganised in a world they can't quite make sense of. Practitioners need to consider their needs and support them to learn strategies.

The following are some suggested activities and or strategies for various difficulties a child may show. They are grouped into five categories: sight, touch, smell and taste, movement and body sense, and sound.

Sight

Holds objects close to eyes

• Eye test to check for short-sightedness
• Help child to filter out irrelevant information and focus on what is important to them

Fascinated by tiny threads on carpet/small patterns

• Place large play mat/cloth on floor to discourage thread pulling and encourage task focus

Stares at fluorescent lighting

• Offer sensory environments as relaxing alternative

Likes to see toys spinning

• Incorporate spinning in play activities, gradually reducing spinning and increasing emphasis on toy function, eg rolling

Excited by flashing lights on toys

• Limit toys to use as motivators for short periods

Turns lights off and or avoids looking at print in books

• Increase natural colours in child's environment
• Keep artificial lights dimmed; increase natural light
• Reduce unnecessary visual information
• Create 'den' or designated area which is visually sympathetic for the child

Touch

Avoids holding hands with adults or children

• Use a no pressure approach and allow child to watch from a distance
• See if child will tolerate adult holding onto a sleeve
• Expose child to range of tactile experiences

Craves rough and tumble play

• Build more gentle play sequences into play
• Include a wind down period in this play and gradually increase time

Holds people tightly; leans on others

• Give firm handshakes or high fives throughout the day
• Play clapping and guess the object by feeling games
• Divert child to pressure toys eg squeezy balls, encourage to press down on a beach ball

Strips off clothing

Analyse what the issue is:

• Are tags rubbing? Remove if possible
• Stick to familiar acceptable clothes and gradually introduce new garments for short periods

A fitted vest/body stocking can sometimes help to comfort against irritating fabrics

Finds nappy change distressing

• Ensure mat is not cool - place towel underneath child when changing
• Determine if child needs firm or light touch and use single quick movements
• Team activity with familiar song or toy

Avoids messy play

• Incorporate familiar toys into messy play, eg car in paint tray
• Let child manipulate materials with long, then short handle tools
• Use Ziploc bags filled with messy materials for close exploration

Doesn't show distress when hurt

• Expose to variations of touch eg light and firm to help child to learn to identify different sensations

Smell and taste

Smells toys before playing

• Show alternative ways of identifying toys, eg by texture
• Use scratch and sniff books during play

Puts objects up nose

• Show child appropriate distance to hold objects when smelling them
• Allow to sniff different fragrances on large pieces of fabric

Eats non-food items

• Intervene and replace with small food item; use small box with seal to encourage child to eat edible items
• Direct to special box of chewable toys (teethers, rings) each time an inedible item is put in mouth

Chews and or mouths everything

• Possibly at stage of development where mouth exploration is dominant
• Provide with range of textured toys/objects to explore with hands

Bites people for no apparent reason

• Could be experiencing overload; approach child slowly from front, not touching child
• Child could wear a small rubber ring to divert to when he feels urge to bite

Eats specific foods only - dry, sloppy, etc

• Gentle taste tests; child is offered very small pieces of new food in between favourites
• Reward for any positive approach to new food such as smelling, touching or holding in mouth
• Exploratory play with various food materials, eg wet spaghetti, porridge oats

Refuses to sit at table to eat

• Adult to model sitting at table with child
• Decrease amount of time child is expected to sit at table; after short period of appropriate sitting, allow to move away to do favourite activity

Licks people and or objects

• Divert child to different ways of identifying people through sight and touch

Movement and body sense

Climbs to excess

• Give lots of opportunity to play on large play equipment
• Play running/catch games

Seeks rocking motion

• Engage in paired play eg row the boat, roly poly song
• Use of a large child sized gym ball to simulate rocking motion

Spins excessively

• Play games where spinning appropriate, eg ring a roses
• Read books that involve swirling actions, eg Bear Hunt

Constantly on the move

• Provide child with regular, frequent bursts of gross motor play
• Reduce time spent on sit down activities

Difficulty negotiating around obstacles

• Raise sight awareness of obstacles with regular reminders
• Put visual markers on fixed obstacles
• Play games involving moving around obstacles

No sense of danger when climbing

• Ensure safety by diverting climbing to appropriate play equipment and reinforcing 'no climbing here'

Difficulty with fine motor skills

• Provide fine motor play opportunities
• Encourage play with tactile manipulative toys, eg squishy balls

Sound

Distressed by loud, sudden noises eg balloon popping, child screaming

• Identifying noise through visual and verbal labelling can reassure, eg 'wow it's the balloon, look!'
• Encourage child to play with object or watch others play with it
• Create fun games, eg blowing up balloon and letting it go, releasing small squeaky bursts of air, etc

Becomes over excited from repetitive sounds

• Use sand timer to show that activity is going to finish
• Limit access to sound before it over-stimulates the child

Distressed by everyday noises eg hand dryer

• Encourage child to stay at distance but in same room, so they can see it but feel protected
• Visually identify sound source to ease anxiety
• Eventually encourage child to move near it...touch it...turn it on

Places hand over others mouth when they sing or talk

• Prepare the child by providing explanation if group are going to sing
• Try to ensure that one adult talks to child at once
• Use soft, calm voice; speak in short, simple sentences

Doesn't respond when spoken to

• Eliminate hearing difficulty
• Provide structured teaching in distraction free area for short periods
• Use child's name at start of any interaction
• Use animation in voice to help child pay attention
• Basic work on identity/name recognition using photographs and labelling tray, chair, etc to support with recognition